| <DIV>BALTIMORE (EGMN) – Utilizing a nicotine patch or bupropion together with a nicotine lozenge was the most effective of five therapies tested for promoting smoking abstinence and avoiding a lapse or relapse into smoking, according to a prospective study of 1,504 smokers.</DIV>
<DIV>All five therapies were “significantly better than placebo in promoting initial abstinence,” Sandra Japuntich, Ph.D., reported at the annual meeting of the Society for Research on Nicotine and Tobacco. </DIV>
<DIV>The therapies also were effective at preventing relapse, said Dr. Japuntich, a postdoctoral fellow at Massachusetts General Hospital’s Mongan Institute for Health Policy, Boston.</DIV>
<DIV>The study’s importance lies in its examination of the effects of each therapy closer to the smokers’ targeted quit dates, Dr. Japuntich said.</DIV>
<DIV>The placebo-controlled trial sought to identify the effects on smoking cessation milestones of five pharmacologic therapies: nicotine lozenge, nicotine patch, bupropion, bupropion with a nicotine lozenge, and nicotine patch with a nicotine lozenge. </DIV>
<DIV>The milestones were one period of 24-hour abstinence within 2 weeks of a target quit date, lapsing with at least one cigarette, and relapsing into regular smoking for at least 7 consecutive days.</DIV>
<DIV>A total of 70% of smokers on placebo initially abstained, compared with 92% of those using a nicotine patch with a nicotine lozenge, 86% on bupropion with a lozenge, 81% on bupropion, 81% on a lozenge, and 88% on a nicotine patch. </DIV>
<DIV>Among those who initially abstained, 83% on placebo lapsed, compared with 70% of smokers who used a nicotine patch with a lozenge, 71% on bupropion with a lozenge, 74% on bupropion, 73% on a lozenge, and 76% on a patch. </DIV>
<DIV>Of those who lapsed, 69% on placebo relapsed, compared with 61% using a nicotine patch, 64% on bupropion with a lozenge, 63% on bupropion, 62% on a lozenge, and 61% on a patch with a lozenge.</DIV>
<DIV>The study’s method provided understanding into the “more precise timing about when medications have effects,” Dr. Japuntich said. “That’s important, because it informs treatment.</DIV>
<DIV>“According to our study, the strongest treatment effects are happening in the first week or two,” she said. “We should know whether medication is working [by then]. If you get past the first week or two on medication and you haven’t lapsed, then the medication is working.”</DIV>
<DIV>On the other hand, for those who do not stay abstinent, “it could be that lapsing and relapsing is an indication that the medication isn’t working, and that the patients might need to try something else,” she said. </DIV>
<DIV>Dr. Japuntich had no conflicts of interest to report. One of her colleagues, Timothy B. Baker, Ph.D., has served as an investigator on research projects sponsored by pharmaceutical companies including Pfizer Inc., Glaxo Wellcome Inc., Sanofi Inc., and Nabi Pharmaceuticals Inc.</DIV>
<DIV>Copyright (c) 2009 Elsevier Global Medical News. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.</DIV>
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<DIV>巴尔的摩(EGMN)——根据一项纳入1,504名吸烟者的前瞻性研究，在所研究的5种治疗方法中，尼古丁贴片或安非他酮联合尼古丁含片的治疗方案能够最有效地促进烟瘾戒除及防止偷吸或复吸。</DIV>
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<DIV>Sandra Japuntich博士在尼古丁和烟草研究协会年会上报告指出，所有5种治疗方法“在促进初步脱瘾方面的疗效显著优于安慰剂。” </DIV>
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<DIV>波士顿马萨诸塞州综合医院Mongan卫生政策研究所的博士后研究员Japuntich博士表示，这些治疗还可有效预防复吸。</DIV>
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<DIV>Japuntich博士表示，该研究的重要意义在于其探讨了每种治疗方法的效果，以明确哪种治疗方法能使吸烟者更接近其目标戒烟日期。</DIV>
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<DIV>该安慰剂对照研究旨在评价以下5种药物治疗对戒烟终点的影响：尼古丁含片、尼古丁贴片、安非他酮、安非他酮+尼古丁含片以及尼古丁贴片+尼古丁含片。 </DIV>
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<DIV>这些终点包括在戒烟开始后2周内持续戒烟24h、偷吸至少1根香烟及常规复吸至少连续7天。</DIV>
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<DIV>初步脱瘾的吸烟者比例在安慰剂组为70%，尼古丁贴片+尼古丁含片组为92%，安非他酮+尼古丁含片组为86%，安非他酮组为81%，尼古丁含片组为81%，尼古丁贴片组为88%。 </DIV>
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<DIV>偷吸的初步脱瘾者比例在安慰剂组为83%，尼古丁贴片+尼古丁含片组为70%，安非他酮+尼古丁含片组为71%，安非他酮组为74%，尼古丁含片组为73%，尼古丁贴片组为76%。 </DIV>
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<DIV>由偷吸变成复吸者的比例在安慰剂组为69%，尼古丁贴片组为61%，安非他酮+尼古丁含片组为64%，安非他酮组为63%，尼古丁含片组为62%，，尼古丁贴片+尼古丁含片组为61%。</DIV>
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<DIV>Japuntich博士表示，该研究方法使我们得以了解“有关药物起效的更确切时间。这具有重要意义，因为它使我们对各种治疗方法有所了解。</DIV>
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<DIV>她说：“根据我们的研究，最强的治疗效果出现在第1周或第2周。我们应清楚药物的作用是否持续到那时。如果吸烟者撑过药物治疗的第1周或第2周，且未偷吸，那么说明药物起了作用。”</DIV>
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<DIV>她表示，另一方面，对于那些未能维持脱瘾的患者，“偷吸和复吸可能提示药物未起作用，这可能需要尝试其他方法进行治疗。” </DIV>
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<DIV>Japuntich博士声明无任何经济利益冲突。她的一位同事——Timothy B. Baker博士——参与了辉瑞、葛兰素威康、赛诺菲和Nabi Pharmaceuticals等制药公司赞助的研究项目。</DIV> |
